Psoas muscle sequestered disc mimicking an intramuscular abscess: A rare case report

Abstract

This report documents a rare case of a sequestered disc in the psoas muscle mimicking an intramuscular abscess, notable for its lack of systemic infection indicators and resolution without surgical intervention. Such cases emphasize the need for accurate differential diagnosis and highlight potential conservative management pathways for sequestered disc herniations. A 57-year-old male presented with acute low back pain following minor weight lifting, unresponsive to NSAIDs. MRI and CT imaging, followed by CT-guided aspiration and cultures, were employed to investigate a nodular structure within the right psoas muscle. Initial imaging suggested an infectious etiology; however, aspiration yielded no material, and cultures were negative. Follow-up MRIs demonstrated improvement and eventual resolution of the lesion, supporting a diagnosis of sequestered disc herniation. This case underscores the importance of considering differential diagnoses for psoas abscess-like presentations and suggests that conservative management may be sufficient in certain cases of sequestered disc fragments.